But the crisis may also be rippling into the economy in complex ways. Goldman Sachs (GS) economist David Mericle said in a research note earlier this month that the opioid epidemic “is intertwined with the story of declining prime-age participation, especially for men.”

The declining labor force participation rate is something of an economic puzzle because the stronger economy should be convincing more Americans to return to the workforce. Instead, the share of American adults with jobs has dwindled by almost 3 percentage points since the recession ended.

Economists have posited causes ranging from weak demand for less-skilled workers to rising disability rates, but as Mericle points out, the trend has also coincided with the opioid crisis.”

“$78.5 billion. That’s the total economic impact of prescription opioid misuse in the United States.

At least that’s what it was in 2013, according to a study conducted by the National Center for Injury Prevention and Control that was released last year.

The price isn’t just shouldered by employers — the criminal justice system and public insurance programs are also feeling the economic pressure. But a significant chunk of it is.

Businesses are mostly seeing their losses in less productive workers who are addicted to opioids, a $20 billion burden. Affected employees miss three times more work days than their healthy counterparts. When they do show up, they don’t get as much done.

Individuals who abuse opioids also cost their employers more in health insurance — about $15,000 more per year, said Curtis Florence, the primary author of the opioid study and the NCIPC’s lead health economist.”